Evidence map›Paper›PMID 41608398›Full record

ReviewStroke (Hoboken, N.J.)2025

Cross-Sectional Imaging Modalities in Correlation to the Thrombolysis in Cerebral Infarction Score: The Next Frontier in Adjunctive Endovascular Stroke Therapy.

Johannes Kaesmacher, Kilian M Treurniet, Manon Kappelhof, Tomas Dobrocky, Johanna Ospel, Adnan Mujanovic, Jens Fiehler, Bernard Yan, Mayank Goyal, Albert J Yoo and 10 more

Abstract readReview
In one paragraph

Review in Stroke (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Johannes KaesmacherUniversity Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital, University of Bern Bern Switzerland.ORCID https://orcid.org/0000-0002-9177-2289
Kilian M TreurnietDepartment of Radiology and Nuclear Medicine Amsterdam UMC Location AMC Amsterdam The Netherlands.
Manon KappelhofDepartment of Radiology The Hague Medical Center The Hague The Netherlands.
Tomas DobrockyUniversity Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital, University of Bern Bern Switzerland.
Johanna OspelDivision of Neuroradiology Clinic of Radiology and Nuclear Medicine University Hospital Basel University of Basel Basel Switzerland.
Adnan MujanovicUniversity Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital, University of Bern Bern Switzerland.
Jens FiehlerDepartment of Neuroradiology University Center Hamburg-Eppendorf Hamburg Germany.
Bernard YanDepartment of Medicine and Neurology Melbourne Brain Centre The Royal Melbourne Hospital University of Melbourne Parkville Australia.
Mayank GoyalDepartment of Radiology and Clinical Neurosciences Foothills Medical Center University of Calgary Calgary Canada.
Albert J YooTexas Stroke Institute Dallas-Fort Worth TX.
Bruce CampbellFlorey Institute of Neuroscience and Mental Health The Royal Melbourne Hospital University of Melbourne Parkville Australia.
Osama O ZaidatDepartment of Neurology Mercy Health Toledo OH.
Jeffrey L SaverDepartment of Neurology and Comprehensive Stroke Center David Geffen School of Medicine University of California Los Angeles CA.
Nerses SanossianRoxanna Todd Hodges Comprehensive Stroke Program Department of Neurology University of Southern California Los Angeles CA.
Radoslav RaychevDepartment of Neurology Mercy Health Toledo OH.
Yvo B W E M RoosDepartment of Neurology Amsterdam UMC Location AMC Amsterdam The Netherlands.
Urs FischerDepartment of Neurology Amsterdam UMC Location AMC Amsterdam The Netherlands.
Charles B L M MajoieDepartment of Radiology and Nuclear Medicine Amsterdam UMC Location AMC Amsterdam The Netherlands.
Jan GrallaUniversity Institute of Diagnostic and Interventional Neuroradiology University Hospital Bern Inselspital, University of Bern Bern Switzerland.
David S LiebeskindDepartment of Neurology and Comprehensive Stroke Center David Geffen School of Medicine University of California Los Angeles CA.ORCID https://orcid.org/0000-0002-5109-8736

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The expanded Thrombolysis in Cerebral Infarction (eTICI) scale is the default method to measure reperfusion success of endovascular treatment for acute ischemic stroke. It is an estimate of the percentage of the vascular territory affected by the initial occlusion, or target downstream territory (TDT), that is reperfused after the intervention. Traditionally, the size of the TDT is determined on the preinterventional catheter angiography images by delineating the antegrade capillary deficit caused by the catheter angiography target occlusion. As such, the current definition of eTICI grading is only suitable to estimate the efficacy of reperfusion strategies occurring after the baseline catheter angiogram. However, reperfusion therapy for acute ischemic stroke due to large vessel occlusion often encompasses intravenous thrombolysis therapy started prior to endovascular treatment but after cross-sectional vascular imaging (computed tomography or magnetic resonance imaging) used to determine eligibility for endovascular treatment. The inherent shortcomings of the current eTICI scale to quantify preinterventional perfusion changes are discussed. We then argue that depending on the timing of the studied intervention - either between cross-sectional imaging and endovascular treatment or after first intracranial catheter angiography - the TDT used to determine the eTICI grade should be based on the occlusion as seen on admission cross-sectional vascular imaging or prethrombectomy catheter angiography, respectively. We propose a new conceptual framework to grade reperfusion based on the TDT derived from the occlusion seen on cross-sectional vascular imaging: the cross-sectional eTICI. Last, we discuss how this definition of the TDT more reliably measures preinterventional reperfusion and establishes homogenous definitions of embolization and infarctions in new territories.

Indexed as

bridgingendovascular treatmentreperfusionthrombectomythrombolysisTICItPA

Identifiers

PMID41608398
PMCPMC11864582

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.